CDC - Centers for Disease Control and Prevention  NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases

NDEP is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations.

You are here: NDEP Home>Health Care Professionals, Businesses & Schools>Transitions>Pediatric to Adult Health Care Transition Planning Checklist

Pediatric to Adult Diabetes Care: Transition Planning Checklist

This checklist helps the health care provider, young adult, and family discuss and plan the change from pediatric to  adult health care. While  a variety of events may affect the actual timing when this change occurs, below is  a suggested timeline and topics for review. The young adult, family, and health care provider can obtain  a copy of this  checklist and access many online transition resources at the NDEP website (www.YourDiabetesInfo.org/transitions).

  • 1 to 2 years before anticipated transition to new adult care providers
    • Introduce the idea that transition will occur in about 1 year
    • Encourage shared responsibility between the young adult and family for:
      • Making appointments
      • Refilling prescriptions
      • Calling health care providers with questions or problems
      • Making insurance claims
      • Carrying insurance card
      • Reviewing blood sugar results with provider between visits
    • Discuss with teen alone: *
      • Sexual activity and safety
      • How smoking, drugs, and alcohol affect diabetes
      • How depression and anxiety affect diabetes and diabetes care
  • 6 to 12 months before anticipated transition
    • Discuss health insurance coverage and encourage family to review options
      • Assess current health insurance plan and new options, e.g. family plan, college plan, employer plan, and healthcare.gov
      • Consider making an appointment with a case manager or social worker
      • Discussion of career choices in relationship to insurance issues
    • Encourage family to gather health information to provide to the adult care team (See Clinical Summary for New Health Care Team at www.YourDiabetesInfo.org/transitions)
    • Review health status: diabetes control, retina (eye), kidney and nerve function, oral health, blood pressure, and lipids (cholesterol)
    • Discuss with teen alone: *
      • Sexual activity and safety
      • Smoking status, alcohol, and other drug use
      • Issues of independence, emotional ups and downs, depression, and how to seek help
  • 3 to 6 months before anticipated transition
    • Review the above topics
    • Suggest that the family find out the cost of current medication(s)
    • Provide information about differences between pediatric and adult health systems and what the young adult can expect at first visit
      • Patient’s responsibilities
      • Other possible health care team members such as a registered dietitian or diabetes educator
      • Confidentiality/parental involvement (e.g., HIPAA Privacy Act and parents need permission from young adult to be in exam room, see test results, discuss findings with health care providers), health care proxy
    • Help identify next health care providers if possible or outline process
    • Discuss upcoming changes in living arrangements (e.g., dorms, roommates, and/or living alone)
  • Last few visits
    • Review and remind of above health insurance changes, responsibility for self‐care, and link to online resources at www.YourDiabetesInfo.org/transitions
    • Obtain signature(s) for release for transfer of personal medical information and for pediatric care providers to talk with the new adult health care providers
    • Identify new adult care physician
      • If known – request consult (if possible) and transfer records/acquire hard copy of most recent records
      • If unknown – ask teen to inform your office when known to transfer records and request consult
    • Review self‐care issues and how to live a healthy lifestyle with diabetes
      • Medication schedules
      • Self‐monitoring of blood glucose schedule
      • Importance of managing diabetes ABCs (A1C, blood pressure, cholesterol)
      • Meal planning, carb counting, etc.
      • Physical activity routine and its effects on blood glucose
      • Crisis prevention‐management of hypoglycemia (low blood glucose), hyperglycemia (high blood glucose), and sick days
      • Need for wearing/carrying diabetes identification
      • Care of the feet
      • Oral/dental care
      • Need for vision and eye exams
      • Immunizations
      • Staying current with the latest diabetes care practice and technology
      • Preconception care (preparing for a safe pregnancy and healthy baby)
    • Discuss with teen alone: *
      • Sexual activity and safety
      • Screening and prevention of cervical cancer and sexually transmitted infection
      • Risk taking behaviors, e.g. tobacco/alcohol/drug use
    • Consider ongoing visits with current diabetes educator as part of transition
    • Suggest options for a diabetes “refresher” course

* For more information on addressing psychosocial issues in adolescents, see the HEEADSSS assessment.

^ top

March 2014

In This Section
Find Publications for Me
How to use this hide info

To find publications specific to your search, select from the options provided below. To view more publications, select fewer options. At least one option must be selected.

Privacy Statement

Also visit these NDEP sites: